Sitting with a mug in her hands, the aroma of ginger tea formed the backdrop against which she told me that she was HIV Positive. *Maryam, my long time friend and colleague, had contracted the disease while working as a medical intern. It was a consequence of being punctured with a needle that had the blood of an HIV positive patient on it—an occupational injury with life-altering consequences. She now takes antiretrovirals daily: drugs, which do not cure the illness, but halt the replication of the virus—thereby improving her quality of life.
This story behind HIV is the exception, but Maryam—my young, Muslimah, hijabi friend—is evidence that HIV knows no barriers and no social, religious or educational distinction.
In different countries, HIV tends to cluster within certain demographic groupings. South Africa ranks in the top five highest HIV prevalent countries globally. In the South African community HIV is closely linked with, but not exclusive to, a low socio-economic status. My own internship and community service experience was clouded by the influx of HIV and AIDS patients into our medical wards. Nighttime reshuffling of patients between wards occurred often because we often ran out of beds. In a country battling with poor resources, HIV/AIDS and its associated conditions have strained our medical facilities to a breaking point. It has, undoubtedly, changed the face and practice of medicine in South Africa.
Aamena Seedat, of the Muslim Aids Program (MAP) based in Johannesburg South Africa, deals with HIV in the Muslim Community, specifically. She believes that while HIV in the South African Muslim community may have been previously confined to those of a lower socio-economic status, HIV prevalence is now “across-the-board,” with people from affluent families contracting the illness. Specializing in youth work, Seedat says that South African Muslim youth, in general, are facing challenges of promiscuity in schools and at university campuses. They are more open to experimenting with drugs and alcohol, both of which are linked to promiscuous sex, and such habits place them at risk for contracting HIV.
The chief challenges according to Seedat, in dealing with HIV in the Muslim community, include stigma and denial. Concerns about social status in the community, pride, shame and the idea that ‘we are supposed to be living correct Muslim lifestyles’ all pose a challenge in educating the Muslim community about HIV. These attitudes are not confined to the Indian Muslim community. MAP works with other migrant communities and with non-Muslims communities as well.
She does, however, go on to say that during the eight years in which she has worked with MAP, she has noticed a general shift in attitudes. People seem to be opening up and are more accepting. She attributes this shift in attitudes partly to the South African department of Health’s education strategy around HIV awareness. Schools now have HIV education as part of their Life Orientation syllabus.
The messages coming from government and leadership also play an important role in managing the spread of the virus. South Africa, unfortunately has suffered from poor leadership that has disseminated mixed messages about HIV/AIDS. Under the previous president, Thabo Mbeki, the denial of AIDS shaped policy. The current president, Jacob Zuma set back some of the strides in HIV education made by civil society, when he claimed that he would not contract HIV after sleeping with an HIV positive woman because he had taken a shower after intercourse. The present health minister, Aaron Motsoaledi appears to be taking a decisive stance, calling on the public to test themselves for HIV—to “know their status.”
Many of the successes around the HIV/AIDS issue in South Africa can be attributed to dedicated and determined civil society organizations. The Treatment Action Campaign (TAC) won a landmark trial against the state, allowing antiretroviral medication (which prevents the spread of HIV from mother to child) to be made available. TAC continues to challenge the government, pushing for greater access to HIV treatment for all South Africans.
Looking at a study led by the Human Sciences Research Council (HSRC), there may to be a light at the end of the tunnel. According to a study presented the 17th Conference on Retroviruses and Opportunistic Infections in San Francisco in 2010, incidences of HIV in South Africa is declining and the impact of antiretroviral treatment is having an effect on the country’s epidemic.
I confess that as a Muslim doctor I previously felt somewhat barred from disease. I thought that my lifestyle was a protective factor. So while I could sympathize with my patients, apart from the occasional needle-stick injury at work, I generally felt an immunity to the disease. Learning my friend Maryam contracted HIV brought the disease to a much more intimate level for me. It was a reminder that in South Africa, even if you a not infected with HIV, you are definitely affected by it.
*Name has been changed to respect privacy
Ayesha Jacub is a medical doctor moonlighting as a mother and wife while she pretends to be a writer.